An Implantable 20-MHz Ultrasonic Doppler Probe for the Postoperative Monitoring of the Buried Free Tissue Transfer: Report of A Case

Abstract

Reconstructive microsurgeon is constantly striving to improve the success and salvage rates of free tissue transfer. Conventional free flap monitoring techniques are reliable for non-buried flaps. Buried flap monitoring is still a dilemma. In 1988, Swartz et al. did the first large-scale study of direct monitoring of microvascular anastomoses with the implantable 20-MHz ultrasonic Doppler probe. We present a case using the Cook-Swartz Doppler blood flow monitoring system for the postoperative monitoring of the buried free forearm flap in pharyngoesophageal reconstruction. It is a simple and reliable method of monitoring microvascular anastomoses without need for intensive care or monitoring units. The venous probe provides a greater degree of sensitivity, particularly to venous occlusion, compared with the arterial probe and has resulted in an increased success and salvage rate. We believed our initial case experience with this device supports the use of Cook-Swartz Doppler blood flow monitoring system as a promising technique for monitoring buried flaps and an adjunct to traditional clinical observation.